Introduction.

Pathological erythrocytoses at altitude affect 10% of the population, representing an important cause of morbidity from non-communicable diseases. Categorizing the severity of such erythrocytoses to estimate their evolution and suitable treatments becomes emergent.

Objective.

To stratify the risk of the pathological erythrocytoses at high altitude considering severity parameters useful for prognosis and treatment.

Material and methods.

Retrospective cross-sectional study that included 283 medical records of patients with Chronic Mountain Sickness-erythrocytosis (CMS-e) or Secondary Erythrocytosis (SE), inhabitants at high altitude (>3600 m a. s. l.) diagnosed between 2000 to 2021. Differential clinical-laboratory characteristics regarding the diagnosis, response to treatment and evolution of patients were identified. Three risk groups (low, intermediate, high) were raised, considering variations about hyperviscosity symptoms, erythropoietin levels, complications, and comorbidities.

Results.

194 patients corresponded to the low-risk group, 67 to the intermediaterisk and 22 to the high-risk. Low-risk group involved Epo <30 mIU/ml, treatment with atorvastatin-aspirin, complete response and a favorable prognosis, grouping mostly CMS-e patients. Intermediate-risk showed Epo >30 mIU/ml (30-100 mIU/ ml), treatment with atorvastatin-aspirin, partial responses and favorable prognosis, concerning patients with SE attributed to mild lung diseases. High-risk reflected Epo >100 mIU/ml, inclusion of hydroxyurea to the treatment with atorvastatin, poor response and unfavorable prognosis, involving patients >60 years of age with SE attributed to severe and chronic lung diseases or complications due to erythrocytosis.

Conclusion.

Counting on a risk stratification for pathological erythrocytosis at high altitude allows to assess the prognosis and optimize therapeutic decisions.

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